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Home My WebLink About2009-00535 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2009-00535 P� � . 2750 KELLEY PARKWAY ORONO, MN 5535C- DATE ISSUED: 09/1U2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 99 SIXTH AVE N PIN : 25-118-23-44-0012 LEGAL DESC : HOLLY ACRES 2ND ADDN : LOT 000 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPA[R PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 6,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) 2 NEW WINDOWS&REMODEL KITCHEN,DINING&LAUNDRY ROOM APPLICANT PERMIT FEE SCHEDULE 132.75 CHOICE WOOD COMPANY PLAN REVIEW 86.29 3300 GORHAM ST.LOUIS PARK,MN 55426 STATE SURCHARGE(VALUATION) 3.00 (612)924-0043 TOTAL 222.04 Minnesota State License#: 1532 OWNER BRISCOE, MR. & MRS. 99 SIXTH AVE N WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and [he State Building Code. This permit is for only the work described and does not gran[permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with t State Building Code.This permit may be revoked an ti e for d �se. -- � q i �� i 0 i i Applica t Permitee Signature Date Issued By i nature - ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB V . � �� -• City of Orono ° r ,,� ��► , . Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: ��g,�,�. PO Box 66 Permit number. � ) - �' � �� Crystal Bay, MN 55323-0066 Date received: �� 7�(��` , � .� � _ �s �,''i � , Received by: a �� (,�> = a, j Street Address: �'.�, � �� ti``'� 2750 Kelley Parkway Plan review ee: 19k�?'�o�� Orono, MN 55356 � �ESH_/ /� �— Total Fee. p3 v��V Main: 952-249-4600 Fax: 952-249-4616 www.ci.ororto.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 9'�j [t>C.t►.TT"� Q,c3�,p ,� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will e required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: �� C�M ��J Name: �C�.��. S C.��o State License# 153 Z Expi ation Date: Phone: 9'S 2- �'Z�l� oo�(3 (office) �yS 2- G Q l - 34�l (cell) MailingAddress: 3gop G,.o,�,L��,e,,v�. �4�� City: 57. Lc�uis P..al�(ZIP: c�� {Z � Contact Person: N(i(�E jas'�' Y52�Z37� 73Y3 Applicant is: on rac o / Homeowner (CircleOne) Email and/or Fax: g52- 2'Z�� DO�i 3 PROPERTY OWNER INFORMATION: Name: D►a.v� �- �,o..-r-r Y $cLtS t—o v`' Phone (day): 6[Z, $O! - 5(6 7� Address: q4 GQc�v�tt�' Roa��O 6 City: Wp�Z.�T'p► ZIP: 55,'�91 Email and/or Fax j��p,UL�b� I�D G-�S . C OtiL PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) �Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) [�Window(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑Siding ❑ Restoration ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Z, �,,��p�y�,�b — REnn.o G 1�(��TC.6�`r�J �l� Estimated Construction Valuation of Project(excluding land) $ � DOfl "' tN cv�t�DcPx o'LZ(G. APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Some or al� of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies re uired b law. If ou refuse to su I the information,the a lication ma not be issued. Applicant's Signature: ` Date: S 2 8� Last Updated: 05-04-2009 � �� Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: `�9 5 i x-rrr q��,P /�1� , Description of work: k �T c i�r„� (��,�,,e,u, �1�,�w�.aKlt�. Septic review by: N/.a► Date Approved: Zoning review by: N/� Date Approved: g �! -Og Building review by: Date Approved: Grading review by: N//� Date Approved: Zoning File#: Resolution#: Resolution e: Zonin District Fire De artment Post Office School District Zoning. Lot Area: SF/AC Width: Depth: Survey Su itted: O Yes 0 No Date of rvey: Pro osed Setb ks: Front(Lake) Rear(Street) ( N S E W ) N S E W ) Other Buildings Wetland Side Side Building Defined Height: � Building Peak Height: FOR A BUILDING WITH A BASEMEN R CRAWL SPACE,Y FOR A BUILDING ON A SLAB FOUNDATION: START the distance betwe the baserfient floor/ START the distance between the slab and the WITH crawl space floor an e hig6(est roof peak, WITH highest roof peak, the top of the cornice the top of the cornice o f �t roof, the deck of a flat roof, the deck line of a mansard line of a mansard roof, or e uppermost � roof, or the uppermost point on a round or oint on a round or oth F arc -t e roof other arch-t e roof SUBTRACT half the distance be en the � hest SUBTRACT half the distance between the highest window and highes roof peak of itched window and highest roof peak of a roof itched roof SUBTRACT the distance be een the basement fl r/ ADD the distance between the slab and the crawl space fl or and the highest existin highest existing grade within the grade within he foundation or 10 feet, foundation whichever�s less. EQUALS Defined buildin hei ht EQUALS Defined uildin hei ht Lot Coverage: SF % Shoreland istrict MCWD Permit Received Avera Lakeshore Setback Bluff � Yes � No � Yes 0 No � N/A p Yes No 0 N/A � Yes � No Permit Number: Setback: Ha cover Zones Existin Pro osed Variance Re 'red CUP Re uired 0-75' 0 Yes � No 0 Yes 0 No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 07/01/2009 z:\forms\plan review checklist.docx .,, Fees to be Char ed YES NO � , Permit ✓ Plan Review ✓ State��tr� ,e �' Investi ation Fee �/' S7AC—:;Al�rnber o�S�►C"Un:its Sewer Connection '`�Iaxe��Con�ec�on' Park Fee �ixe-�n �ec#ion Other s eci Nliscel�ar�eous'�ees ' Calculated B : UBC: �2' Construction Type: �! S uare Foota e $ er S uare Foota e Basement X = $ 1 Fioor X = $ 2" FIOOf X = $ Gara e X = $ Estimated Construction Value: � Orono insaections Reauired Work Reauirina Seaarate Permits Required State Permits � Site �'Plumbing 0 Grading/ Filling � Well � Hardcover Removal .B'Mechanical 0 Fire �'1 Electrical � Footing 0 Septic O Water Connection 0 Foundation Survey 0 Fireplace 0 Sewer Connection .0' Framing � Masonry O Lawn Irrigation p� Insulation 0 Mfg. � 0 Wall Board 0 Other(specify) � As-Built Survey �Final � Other s eci REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: 0 YES � NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 07/01/2009 z:\fortns�plan review checklist.docx _, J � T TIME `� CITY OF ORONO CALLED IN 9 � INSPECTION NOTICE scHE�u�eo �� PERMIT NO.a0�0�"o�S3 S COMPLETED ADDRESS 94 S OWNER CONTR. 4a TELEPHONE NO. �2—2-3�" ��•3 � DESCRIPTION � . � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: ¢ W a � � O .� � O � W � Q � � 2 W � W � � � RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑COR T WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCV 0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�IERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-4600 Owner/ConVactor on site• Inspector. � White Copyllnspector's File Canary Copy/Site NoHce �i/ e s'�`� ' -�AJ� / TIME `� CITY OF ORONO CALLED IN ��-�'��`�� INSPECTION I HEDULED � �' PERMIT NO. � �53�MP�ETED ADDRESS � OWNER C NTR. TELEPHONE NO. S � 7' 7�J � DESCRIPTION ` " /��i� � !/�/�'n�vKu � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q p FRAMING ❑ MECHANICAL FINAL ❑ IAKESHORENVETLANDS y ❑ INSULATION p WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q 1�"F(NAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBiNG FINAL 0 FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J � �' S SlM� � � j^�O�v1 ° ��L�� W - � Q � z W � W � � � O W� ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector._� � � White Copyllnspector's File Canary CopylSfte Noti�